hello all. i'm a 26 year old healthy female that was diagnosed with a fistula on Nov. 4. i suffered from what i thought was hemorrhoids in sept but learned i must have had an abscess that turned into a fistula in that time. my surgery is scheduled for dec. 12 but my CRS is not sure what procedure he is going to do until i'm under anesthesia. he told me my case is slightly complicated because my fistula is anterior. he did offer the options of fistulomy, plug, seton, and lift. i'm hoping that because i have not had this fistula that long that it's not that bad and wont need multiple procedures. besides the fistula being very annoying it doesn't affect my daily life all that much. it does drain a little most days and i do experience a short but pretty intense amount of pain after a BM (but not every one- i have a BM every morning and maybe experience this pain 2/3 out of 7 days). so i'm just wondering if what i'm describing is typical fistula behavior or is mine possibly more manageable than what most people experience?

also a couple more questions...

right now i'm planning on taking off 8 days after surgery...does this seem like enough? i am a social worker and primarly work at my desk or drive quite a bit to see clients...

i play volleyball once a week...how soon can i resume this?

are there any other women who had an experience with an anterior fistula and what procedure was done for you?

if my fistula drains on a regular basis what are the chances i will still need a seton to drain it?

if i have a seton placed can i have sex? i'm sure i should wait a few weeks after the procedure? most likely i will be extremely self conscious about this so sex probably won't happen anyway, but i'm just curious

thank you so much to anyone who responds!!!

Hi HK,
Sorry you have to be here dealing with a fistula but welcome.
I also suffered an abscess that turned into a fistula. I caught it very quickly - the moment the abscess popped, I was well aware of the possibility of a fistula development and was able to almost self-diagnosis immediately and I know that helped me a lot because it was a lot easier to catch & treat. I needed no more than a simple fistulomy, which took 20 mins to fix with an uncomplicated recovery process. Nearly 2 years on, I'd never have know I had this issue.
I really do believe that the quicker you start dealing with these things, the better your situation.
It could be that even though your CRS believes it could be more complicated, that it could be nothing more than a fistulomy that will help you sort this - A seton will be inserted if the fistula tract interacts with the internal sphincter muscle but a lot of people have these and recover very successfully. They can be a little uncomfortable to get used to but most people find them less bothersome after a while and then of course, they come out anyway. Sometimes the Seton will be inserted straightaway and then the Fistulomy performed once the drainage process seems to be complete, but these are nothing to worry about. Even if your fistula is draining a lot now, they will still use a seton if the tract goes through the sphincter.
Hopefully you will find that post-surgery will be no less painful than before & you should go on to make a full recovery once all the nastiness has been removed and cleared.
My fistula also never bothered me to a huge extent - my biggest discomfort was the inflammation when the opening began to fill with pus in that cycle - once it started to drain again, there was always relief and I hoped it would just go away, only it never did, which made me believe that you can't heal these things without surgery.
It's always a little uncomfortable of course after the surgery, but nothing majorly painful, and you will need to make sure you are keeping your stools nice and soft through good eating and lots of liquids, so as to minimise any pressure from straining when you go for a BM, but taking a stool softener for a few weeks whilst you recover will also help a lot.
I returned to work 10 days after my op and was actually OK. It was a little uncomfortable getting in and out of my car - I think that was the most uncomfortable part for me but I felt absolutely fine otherwise. If your process is straight forward, then 8 days should be OK but just make some alternative plans if you can, just in case the surgery is more complex, as it's good to get that recovery time after (more than anything just to use the comforts of your own bathroom!)
Full recovery time depends on the individual, the surgery etc. but if everything is straightforward, it can take around 4-6 weeks for a fistula wound to fully heal (although you can resume normal activities long before this!)
It might be helpful to rest up as much as you can afterwards but you should be able to resume your activities pretty quickly afterwards - I'm guessing you might be advised a couple of weeks rest but it shouldn't hinder your Volleyball for too long!
Sex is absolutely fine with a seton too - It depends on how you feel and how conscious you are about it all but the seton itself won't cause issues with that process - it really is up to how comfortable you feel in yourself and when you feel the time is right for you again.
Hopefully, because this was caught so soon, your surgery & recovery will not be so long and they can sort you out pretty quickly - some fistulae lie undetected for a long time and it tends to be these that can create on-going issues with multiple surgeries.
I would just say try not to worry too much at all and take each day as it comes - Fistula surgery is not the worst & most painful surgery you could be facing & within a few months, hopefully, it should all be sorting itself out for you. Feel free to pop back any time for more info! & all the very best to you :)
All the very best with your forthcoming surgery!!

Hello! Welcome to the site! I myself will be going on my third surgery in dec , I currently have a seton in place. I'm male, sex is not the same lol. I can't really get into it like I used to! Wife is prego so proof it is still possible! On the two surgeries I have had, I was out about a week on both. My pain was up there, I was prescribed tramadol. Everyone has a diff story so don't be frightened. Only you can say when you can return to regular activities. Don't push yourself too hard, take it slow and easy. Please keep us updated.

thank you so much ever the optimist. i actually received the completed fmla paperwork from my crs today and he listed fistulotomy as the procedure even though he told me a few options at my original appointment- but i assume this could change once he gets in there. the way you described the discomfort you had with your fistula prior to surgery is basically the same experience i'm having- so i'm hoping this means it's not as complicated dealing with a sphincter- i would assume i would be in more pain on a daily basis if that was the case?

HK,
Fingers crossed it's just the fistulomy for you & you heal as well as I was able to!
I think it's a good sign he listed the fistulomy as the procedure but they have to advise you of the other options too anyway just in case they do have to undertake an alternative.
I really couldn't say exactly why one fistula may be more painful or more uncomfortable than another - other than down to the location of the thing, but in my experience, it was never painful just uncomfortable, annoying and frustrating!......Post op pain was not much worse than how it all was before.
Some people have fistulas for years! and it really doesn't bother them (some actually prefer to leave their condition as it is......) but they can form multiple tracts and lead to complications with infection etc.
In my opinion, the sooner removed, the better!! :)

Hello all! I had my surgery today and ended up having a plug inserted. The crs said the tract was short but did go through muscle but that it was rather simple. What made mine complicated is that it sorta near the perinium. He said he has done the plug with other patients similar to me and it has been successful. My pain meds from the hospital are wearing off but I'm holding off on taking more meds to see how much pain I'm in.

Hope you're feeling okay and on the road to healing!

Just wanted to give you some feedback regarding your questions (sorry about the caps lock.. I'm not yelling :P):

**right now i'm planning on taking off 8 days after surgery...does this seem like enough? i am a social worker and primarly work at my desk or drive quite a bit to see clients...
THIS IS PROBABLY FINE - I FOUND THAT THE FIRST 5 DAYS POST-SURGERY TEND TO BE ROUGH. I'VE HAD 3 SURGERIES AND TAKEN OFF 10 DAYS AND 2 WEEKS DEPENDING ON THE PROCEDURE. I FOUND I STARTED TO FEEL SLIGHTLY "NORMAL" AGAIN AFTER ABOUT 1 WEEK EACH TIME. GIVEN THAT YOU'VE HAD THE PLUG SURGERY, I'VE HEARD YOU NEED TO TAKE IT EASY TO LET YOU BODY "TAKE" - I WOULD DEF TAKE OFF WHATEVER LENGTH OF TIME YOUR SURGEON HAS RECOMMENDED.

i play volleyball once a week...how soon can i resume this?
REALLY DEPENDS ON THE PERSON - I WAS BACK IN THE GYM ABOUT 4-5 WEEKS AFTER SURGERY - CARDIO CLASSES AND YOGA. YOU'LL KNOW WHEN YOU'RE READY. DON'T PUSH YOURSELF FOR A FEW WEEKS THOUGH.

are there any other women who had an experience with an anterior fistula and what procedure was done for you?
I REALLY SHOULD KNOW WHAT TYPE OF FISTULA THAT IS - BUT I DON'T SEEM TO RECALL! :) I HAD A FISTULA THAT BRANCHED INTO 2 TRACTS, CAUSING 2 ABSCESSES - THIS ALL STARTED OFF DUE TO AN ABSCESS. I HAD SETONS PLACED TWICE, AND FINALLY THE LIFT PROCEDURE AS ONE TRACT WENT THROUGH MUSCLE. I WOULD SAY I AM 95% HEALED AT THIS POINT.

if my fistula drains on a regular basis what are the chances i will still need a seton to drain it?
I BELIEVE IT NEEDS TO DRY OUT/STOP DRAINING FOR IT TO FULLY HEAL. GIVEN THAT YOU HAVE A PLUG NOW, I ASSUME THE SETON IS NOT NEEDED UNLESS THE PLUG DOESN'T WORK FOR SOME REASON?

if i have a seton placed can i have sex? i'm sure i should wait a few weeks after the procedure? most likely i will be extremely self conscious about this so sex probably won't happen anyway, but i'm just curious
I HAVE ANOTHER THREAD ON HERE ABOUT HATING NOT HAVING A GOOD SEX LIFE FOR YEARS :)
YOU'LL KNOW WHEN YOU'RE READY - I WAS VERY SELF CONSCIOUS BECAUSE EVERYTHING WAS VERY CLOSE TO MY "LADY PARTS" AND THE WHOLE AREA WAS JUST FEELING VERY BLAH!

Thank you. Anterior means that my fistula is closer to the vagina rather than the back of the anus(posterior). I have to admit the pain got much worse last night and I probably only slept 2 hours. I even took the Percocet which relieved the pain for about an hour during the night. Then around 7 am the pain was more tolerable and I slept a bit more. My next big scare is having a bm. I assume it will be awful. I'm just slightly starting to feel an urge to go which kinda relieves me that hopefully the pAin meds aren't making me totally constipated. I plan on taking some miralax soon. Any other advice on this?

That's like mine then - the initial abscess was very close to my vagina so they actually didn't know what was going on. They thought it may have been a bartholin cyst due to the location. I think I would have actually preferred a posterior "situation" - easier to deal with as a woman. Not that one is actually better than the other.

I have taken a LOT of percocet - take it if you need it. It does help a lot with the pain - if anything it sends you to a "happy place" :) Make sure you take the stool softeners, laxatives and lots of water if you're on percocet. I had BAD constipation twice from it and would never wish that on my worst enemy. The BM isn't going to be that bad - mine never were other than the constipation instances. Eat lots of fruit and other sources of fiber - lots of water! Vitamin C helps too.

Just wanted to update... I'm feeling okay lately still taking it easy and plan on going back to work Monday. I finally had a bm today that was normal. I didn't strain that much but I guess I'm afraid to push even a little for fear of the plug popping out or that I might bust a stitch or something. The actual site of my fistula doesn't bother me much except for the bleeding. I have more pain from my anus in general- sometime it's a raw and burning pain or I'll get shocks of pain not near my fistula. Is this normal? Does my anus hurt because of the surgery in general and that tool that keeps the hole open?